Prevalence and risk factors of anaemia among men: A study based on Empowered Action Group states, India

Prevalence of anemia and its social determinants among the male residents of an urban area in Tamil Nadu, India

Introduction

India has a high burden of anemia among the South Asian countries. Anemia has been extensively studied in the female and child population, with less attention given to males. The present study aims to assess the prevalence of anemia among males residing in an urban area and associated social determinants.

Methods

A community-based cross-sectional study was conducted among 300 males (during September and October 2021) in an urban area of Coimbatore, Tamil Nadu. A portable hemoglobin photometer was used to detect the prevalence of anemia. A structured questionnaire was used to collect details on social determinants of anemia such as dietary practice, education, income, and sanitary practices.

Results

The mean age of study participants was 34 ± 5.23 years. The prevalence of overall anemia among men was 20.3% (95% confidence interval [CI]: 15.9-25.3%), with moderate and severe anemia being 5.7% (95% CI: 3.3-8.9%) and 1% (95% CI: 0.2-2.9%), respectively. Belonging to a lower socioeconomic class (odds ratio [OR] = 6.50, P < 0.05) and consuming more than two cups of tea (OR = 7.28, P < 0.05) were significantly associated with anemia.

Conclusion

Our study depicts a high burden of anemia among males. Health education on the role of dietary factors contributing to anemia needs to be emphasized with special focus on the frequency of tea intake. Primary care physicians can include screening for anemia in their routine practice for men belonging to lower socioeconomic groups. Consideration should be made to include male populations also under the National Anemia Control program.

A district-level geospatial analysis of anaemia prevalence among rural men in India, 2019-21

BACKGROUND

Despite its considerable impact on health and productivity, anemia among men has received limited attention. In a country as diverse as India, characterized by extensive geographic variations, there is a pressing need to investigate the nuanced spatial patterns of anemia prevalence among men. The identification of specific hotspots holds critical implications for policymaking, especially in rural areas, where a substantial portion of India's population resides.

METHODS

The study conducted an analysis on a sample of 61,481 rural men from 707 districts of India, utilizing data from the National Family Health Survey-5 (2019-21). Various analytical techniques, including Moran's I, univariate LISA (Local Indicators of Spatial Association), bivariate LISA, and spatial regression models such as SLM (Spatial Lag Model), and SEM (Spatial Error Model) were employed to examine the geographic patterns and spatial correlates of anaemia prevalence in the study population.

RESULTS

In rural India, three out of every ten men were found to be anemic. The univariate Moran's I value for anaemia was 0.66, indicating a substantial degree of spatial autocorrelation in anaemia prevalence across the districts in India. Cluster and outlier analysis identified five prominent 'hotspots' of anaemia prevalence across 97 districts, primarily concentrated in the eastern region (encompassing West Bengal, Jharkhand, and Odisha), the Dandakaranya region, the Madhya Pradesh-Maharashtra border, lower Assam, and select districts in Jammu and Kashmir. The results of SLM revealed significant positive association between anaemia prevalence at the district-level and several key factors including a higher proportion of Scheduled Tribes, men in the 49-54 years age group, men with limited or no formal education, individuals of the Muslim faith, economically disadvantaged men, and those who reported alcohol consumption.

CONCLUSIONS

Substantial spatial heterogeneity in anaemia prevalence among men in rural India suggests the need for region-specific targeted interventions to reduce the burden of anaemia among men in rural India and enhance the overall health of this population.

Predictive association of gut microbiome and NLR in anemic low middle-income population of Odisha- a cross-sectional study

Background

Iron is abundant on earth but not readily available for colonizing bacteria due to its low solubility in the human body. Hosts and microbiota compete fiercely for iron. <15% Supplemented Iron is absorbed in the small bowel, and the remaining iron is a source of dysbiosis. The gut microbiome signatures to the level of predicting anemia among low-middle-income populations are unknown. The present study was conducted to identify gut microbiome signatures that have predictive potential in association with Neutrophil to lymphocytes ratio (NLR) and Mean corpuscular volume (MCV) in anemia.

Methods

One hundred and four participants between 10 and 70 years were recruited from Odisha's Low Middle-Income (LMI) rural population. Hematological parameters such as Hemoglobin (HGB), NLR, and MCV were measured, and NLR was categorized using percentiles. The microbiome signatures were analyzed from 61 anemic and 43 non-anemic participants using 16 s rRNA sequencing, followed by the Bioinformatics analysis performed to identify the diversity, correlations, and indicator species. The Multi-Layered Perceptron Neural Network (MLPNN) model were applied to predict anemia.

Results

Significant microbiome diversity among anemic participants was observed between the lower, middle, and upper Quartile NLR groups. For anemic participants with NLR in the lower quartile, alpha indices indicated bacterial overgrowth, and consistently, we identified R. faecis and B. uniformis were predominating. Using ROC analysis, R. faecis had better distinction (AUC = 0.803) to predict anemia with lower NLR. In contrast, E. biforme and H. parainfluenzae were indicators of the NLR in the middle and upper quartile, respectively. While in Non-anemic participants with low MCV, the bacterial alteration was inversely related to gender. Furthermore, our Multi-Layered Perceptron Neural Network (MLPNN) models also provided 89% accuracy in predicting Anemic or Non-Anemic from the top 20 OTUs, HGB level, NLR, MCV, and indicator species.

Conclusion

These findings strongly associate anemic hematological parameters and microbiome. Such predictive association between the gut microbiome and NLR could be further evaluated and utilized to design precision nutrition models and to predict Iron supplementation and dietary intervention responses in both community and clinical settings.

Prevalence and determinants of anaemia among men in rural India: Evidence from a nationally representative survey

Anaemia among men is a significant health issue which has not been given due importance. Only a handful of studies have captured the prevalence of anaemia among men. There is dearth of evidence base on anaemia among men in India. Therefore, this study attempts to fill this research gap by examining the socioeconomic, geographic, health-related, and behavioural differentials of anaemia among rural men in India. We analysed a cross-sectional sample of 61,481 men aged between 15-54 and living in rural areas from the National Family Health Survey (NFHS-5), conducted in 2019-21. Bivariate statistics and multivariable logistic regression were employed to assess the factors associated with anaemia. In rural India, three out of ten men were found to be anaemic. Older men [49-54 years] (Odds Ratio: 1.10, 95% CI, 1.00-1.21), men without a formal education (OR: 1.36, 95% CI, 1.26-1.47), those from Scheduled Tribes (OR: 1.48, 95% CI, 1.39-1.58) and men who belonged to the poorest wealth quintile (OR: 1.24, 95% CI: 1.25-1.35) had a higher risk of anaemia. Men who were underweight were more likely to be anaemic (OR: 1.36, 95% CI: 1.30-1.43). When compared to the central region, men from the eastern (OR: 1.47, 95% CI: 1.39-1.55) parts of India had higher a risk of anaemia. The findings suggest the need to recognise anaemia among men as a public health issue. When developing policy, significant variation in socioeconomic, geographic, health-related, and behavioural factors must be taken into account. Men should also be screened on a regular basis in order to reduce the national burden of anaemia.

Socio-economic inequality in anaemia among men in India: a study based on cross-sectional data

BACKGROUND

Undernutrition is a serious matter of public health concern in India. Existing studies, policies and programs focus on women and children thereby ignoring men in policymaking. This study examines the socio-economic inequality in anaemia levels among men in India and tries to decompose the factors behind it.

METHODS

The fourth round of National Family Health Survey is used to fulfill the study objectives. The outcome variable of the study is men having anaemia or not. The study uses bivariate and multivariate techniques to identify the factors associated with the outcome variable. Further, concentration index and concentration curve are calculated to measure the socio-economic inequality in anaemia among men in India.

RESULTS

The results indicate that majority of the socio-economic related inequality is explained by wealth quintile followed by geographical regions of India, body mass index and educational attainment. The results also emphasize that older men belong to the high-risk groups. Moreover, the likelihood of anaemia is 40% more likely among men who belonged to East region and 25%, 13% and 7 % less likely among those who belonged to Northeast, West and South region compared to those who belonged in the North region of the country.

CONCLUSION

Existing policies on anaemia should include men to achieve an anaemia free India. Individual education and awareness should be encouraged to improve nutritional status.

Anaemia among mother-father-child pairs in India: examining co-existence of triple burden of anaemia in a family

BACKGROUND

Anaemia is a global health concern and is also a common comorbidity in multiple medical conditions. Very limited research is available examining anaemia among family members in India and across various countries. The present study aimed to examine the co-existence of the triple burden of anaemia among mother-father-child pairs in a family.

METHODS

The data utilized was from the National Family Health Survey conducted in 2015-16. The effective sample size for the study was 26,910 couples, along with children aged 6-59 months. The bivariate and binary logistic regression analysis were applied to assess the factors associated with family-level anaemia. In bivariate analysis, a chi-square test was performed to determine the association of socio-demographic factors with anaemic family.

RESULTS

More than half of the mothers (57.5%) and their children (58%), along with 10% of fathers, were found to be anaemic; however, the co-existence of triple burden of anaemia among mother-father-child pairs was 4.7% in the study. The likelihood of family-level anaemia was low when both the parents were educated [OR: 0.69, CI: 0.58-0.81], and it was high when both the parents were employed [OR: 1.40 CI: 1.10-1.80]. Families from the Scheduled Tribe had a 62% higher likelihood to suffer from anaemia [OR: 1.62, CI: 1.33-1.97].

CONCLUSIONS

The suggested interventions include early diagnosis, effective management, and treatment of anaemia. Moreover, adequate complementary feeding practices for children shall also be promoted. Parental education on nutrition is also required, and community interventions are needed to improve parental education on nutrition. At last, there is a need for greater policy and program attention to improving nutritional knowledge among mothers so as to tackle the triple burden of anaemia among mother-father-child pairs.